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EFFECTS OF EARLY AGGRESSIVE NUTRITION ON VLBW INFANTS

早期积极营养对极低出生体重婴儿的影响

基本信息

批准号：
6896241
负责人：
SUDHA KASHYAP
金额：
$ 29.43万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
1993
资助国家：
美国
起止时间：
1993-07-01 至 2007-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6896241
关键词：
bioenergetics body weight child physical development clinical research clinical trials developmental neurobiology developmental nutrition diet therapy dietary proteins human subject human therapy evaluation low birth weight infant human nutrition related tag parenteral feedings patient oriented research postnatal growth disorder weight gain

项目摘要

DESCRIPTION (Scanned from the applicant's description): A recent NICHD sponsored work shop reported that extremely low birth weight infants experience poor or no growth for the first several days to weeks of life. There is considerable evidence that these early growth deficits have long lasting effects including short stature and poor neurodevelopmental outcomes. The participants concluded that there was urgent need for research to evaluate short and long term metabolic, growth and neurodevelopmental responses of these infants to earlier and more aggressive nutritional management. Results of our recently completed enteral feeding studies highlighted important differences in the growth and nutritional status of VLBW infants. When compared to infants weighing 125 1-1600 g, infants weighing 750-1250 g at birth had significantly lower lengths and head circumference at discharge (weight 2200g). Preservation of weight gain in the face of slower linear growth and head growth is consistent with relative nitrogen deficiency; this interpretation is strengthened by the finding of lower plasma transthyretin concentrations in these infants. Furthermore, it took the smaller infants longer to achieve the desired enteral intakes and to regain birth weight. On the basis of these observations, we hypothesized that an early period of relative nitrogen deficiency underlies the growth failure seen in VLBW infants. To test this hypothesis we propose a randomized, prospective clinical trial to compare an aggressive early nutritional regimen providing 18 percent of energy intake as protein (P:E ratio of 4.5 g:l00 kcal) to a conventional regimen providing 12.5 percent of energy intake as protein (P:E ratio of 3.1 g:100 kcal) in appropriate for gestational age VLBW infants. The outcome of the nutritional intervention will be assessed by measurements of growth, rate and composition of weight gain and nutritional status made at the time parenteral nutrition is discontinued, and at discharge, as well as the neuro-developmental outcome at 18 months corrected age.

描述（从申请人的描述扫描）：最近的NICHD 赞助的工作室报告说，极低出生体重婴儿的经验，在生命的最初几天到几周内生长不良或没有生长。有大量证据表明，这些早期的增长赤字将长期存在，影响包括身材矮小和神经发育不良的结果。的与会者得出结论认为，迫切需要进行研究，短期和长期代谢、生长和神经发育反应更早更积极的营养管理。成效最近完成的肠道喂养研究强调了极低出生体重儿的生长和营养状况。与婴儿相比，体重125 1-1600 g，出生时体重750-1250 g的婴儿，出院时的下半身和头围（体重2200 g）。保存在缓慢的线性增长和头部增长的情况下，与相对氮缺乏一致;这种解释是血浆甲状腺素运载蛋白浓度较低的发现加强了这一点。这些婴儿。此外，较小的婴儿需要更长的时间才能达到期望的肠内摄入量和恢复出生体重。根据这些观察，我们假设，早期的相对氮缺乏是VLBW婴儿生长失败的基础。为了验证这一假设我们提出了一个随机的，前瞻性的临床试验，以比较积极的早期营养方案提供18%的能量摄入，蛋白质（P：E比率为4.5g：100 kcal）与常规方案相比提供12.5 以蛋白质计的能量摄入百分比（P：E比为3.1 g：100 kcal）适合胎龄极低出生体重儿。营养的结果将通过测量生长、速率和组成来评估干预措施体重增加和营养状况的时候，肠外营养是停药和出院时，以及神经发育结局 18个月矫正年龄